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Subarachnoid hemorrhage randomized

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https://www.readbyqxmd.com/read/29846713/outcome-after-clipping-and-coiling-for-aneurysmal-subarachnoid-hemorrhage-in-clinical-practice-in-europe-usa-and-australia
#1
(no author information available yet)
BACKGROUND: Within randomized clinical trials (RCTs), coiling of the ruptured aneurysm to prevent rebleeding results in better outcomes than clipping in patients with aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: To study the association of coiling and clipping with outcome after aSAH in daily clinical practice. METHODS: In this controlled, nonrandomized study, we compared outcomes after endovascular coiling and neurosurgical clipping of ruptured intracranial aneurysms in an administrative dataset of 7658 aSAH patients (22 tertiary care hospitals from Europe, USA, Australia; 2007-2013)...
May 29, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29804416/-effect-and-significance-of-mild-hypothermia-on-cerebral-blood-flow-velocity-and-cerebral-extraction-rate-of-oxygen-in-patients-with-severe-subarachnoid-hemorrhage
#2
T Shui, Z Y Guo, G Z Zhang, Q Chen, B Li
Objective: Through studying the variations of cerebral blood flow velocity and cerebral extraction rate of oxygen to investigate the effect and mechanism of mild hypothermia therapy on early brain injury (EBI) and cerebral vasospasm (CVS) induced by sever subarachnoid hemorrhage (SAH). Methods: A total of 62 adult patients admitted in the Department of Neurosurgery of Tianjin TEDA Hospital from January 2014 to December 2016 with severe SAH without contraindications of hypothermia therapy were randomly divided into mild hypothermia (MH) group of 30 cases and routine treatment (RT) group of 32 cases...
May 22, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29804158/impact-of-echocardiographic-wall-motion-abnormality-and-cardiac-biomarker-elevation-on-outcome-after-subarachnoid-hemorrhage-a-meta-analysis
#3
REVIEW
Limin Zhang, Bing Zhang, Sihua Qi
Cardiac abnormalities (echocardiographic wall motion abnormality (WMA), biomarker elevation of cardiac troponin (cTn), B-type natriuretic peptide (BNP), or N-terminal prohormone of B-type natriuretic peptide (NT-proBNP)) frequently occur after subarachnoid hemorrhage (SAH). The clinical significance of cardiac abnormalities after SAH remains controversial. This meta-analysis was performed to assess the association between cardiac abnormalities and patient outcomes, including delayed cerebral ischemia (DCI), poor outcome, and death in SAH patients...
May 26, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29799344/spreading-depolarization-in-acute-brain-injury-inhibited-by-ketamine-a-prospective-randomized-multiple-crossover-trial
#4
Andrew P Carlson, Mohammad Abbas, Robert L Alunday, Fares Qeadan, C William Shuttleworth
OBJECTIVE Retrospective clinical data and case studies support a therapeutic effect of ketamine in suppression of spreading depolarization (SD) following brain injury. Preclinical data strongly support efficacy in terms of frequency of SD as well as recovery from electrocorticography (ECoG) depression. The authors present the results of the first prospective controlled clinical trial testing the role of ketamine used for clinical sedation on occurrence of SD. METHODS Ten patients with severe traumatic brain injury (TBI) or aneurysmal subarachnoid hemorrhage (SAH) were recruited for this pilot trial...
May 25, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29773103/-curcumin-alleviates-early-brain-injury-following-subarachnoid-hemorrhage-in-rats-by-inhibiting-jnk-c-jun-signal-pathway
#5
Xia Li, Ji Zhu
Objective To investigate the inhibitory effect of curcumin on early brain injury following subarachnoid hemorrhage (SAH) by inhibiting JNK/ c-Jun signal pathway. Methods Sixty adult male SD rats were randomly divided into four groups: sham operation group (sham group), SAH group, SAH group treated with 100 mg/(kg.d) curcumin and SAH group treated with 200 mg/(kg.d) curcumin, with 15 rats in each group. Endovascular puncture was used to induce SAH model. Nissl staining was used to test whether neurons were broken...
March 2018: Xi Bao Yu Fen Zi Mian Yi Xue za Zhi, Chinese Journal of Cellular and Molecular Immunology
https://www.readbyqxmd.com/read/29770118/neuroinflammation-as-a-target-for-intervention-in-subarachnoid-hemorrhage
#6
REVIEW
Airton Leonardo de Oliveira Manoel, R Loch Macdonald
Aneurysmal subarachnoid hemorrhage (SAH) is a sub-type of hemorrhagic stroke associated with the highest rates of mortality and long-term neurological disabilities. Despite the improvement in the management of SAH patients and the reduction in case fatality in the last decades, disability and mortality remain high in this population. Brain injury can occur immediately and in the first days after SAH. This early brain injury can be due to physical effects on the brain such as increased intracranial pressure, herniations, intracerebral, intraventricular hemorrhage, and hydrocephalus...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29749915/continuous-infusion-of-low-dose-unfractionated-heparin-after-aneurysmal-subarachnoid-hemorrhage-a-preliminary-study-of-cognitive-outcomes
#7
Robert F James, Nicolas K Khattar, Zaid S Aljuboori, Paul S Page, Elaine Y Shao, Lacey M Carter, Kimberly S Meyer, Michael W Daniels, John Craycroft, John R Gaughen, M Imran Chaudry, Shesh N Rai, D Erik Everhart, J Marc Simard
OBJECTIVE Cognitive dysfunction occurs in up to 70% of aneurysmal subarachnoid hemorrhage (aSAH) survivors. Low-dose intravenous heparin (LDIVH) infusion using the Maryland protocol was recently shown to reduce clinical vasospasm and vasospasm-related infarction. In this study, the Montreal Cognitive Assessment (MoCA) was used to evaluate cognitive changes in aSAH patients treated with the Maryland LDIVH protocol compared with controls. METHODS A retrospective analysis of all patients treated for aSAH between July 2009 and April 2014 was conducted...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29733918/complication-rate-of-intraarterial-treatment-of-severe-cerebral-vasospasm-after-subarachnoid-hemorrhage-with-nimodipine-and-percutaneous-transluminal-balloon-angioplasty-worth-the-risk
#8
Daniela Adami, Joachim Berkefeld, Johannes Platz, Jürgen Konczalla, Waltraud Pfeilschifter, Stefan Weidauer, Marlies Wagner
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a complication of aneurysmal subarachnoid hemorrhage (SAH). Arterial cerebral vasospasm (CVS) is discussed as the main pathomechanism for DCI. Due to positive effects of per os nimodipine, intraarterial nimodipine application is used in patients with DCI. Further, percutaneous transluminal balloon angioplasty (PTA) is applied in focal high-grade spasm of intracranial arteries. However, clinical benefits of those techniques are unconfirmed in randomized trials so far, and complications might occur...
May 4, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29710495/phosphodiesterase-4-inhibition-confers-a-neuroprotective-efficacy-against-early-brain-injury-following-experimental-subarachnoid-hemorrhage-in-rats-by-attenuating-neuronal-apoptosis-through-the-sirt1-akt-pathway
#9
Qun Li, Yucong Peng, Linfeng Fan, Hangzhe Xu, Pingyou He, Shenglong Cao, Jianru Li, Ting Chen, Wu Ruan, Gao Chen
Phosphodiesterase-4 (PDE4) plays a fundamental role in a range of central nervous system (CNS) insults, however, the role of PDE4 in early brain injury (EBI) after subarachnoid hemorrhage (SAH) remains unclear. The current study was designed to investigate the role of PDE4 in EBI after SAH and explore the potential mechanism. The SAH model in Sprague-Dawley rat was established by endovascular perforation process. Rats were randomly divided into: sham group, SAH?+?vehicle group, SAH?+?rolipram (PDE4 inhibitor) group, SAH?+?rolipram?+?sirtinol (SIRT1 inhibitor) group and SAH?+?rolipram+MK2206 (Akt inhibitor) group...
March 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29701554/long-term-results-of-middle-cerebral-artery-aneurysm-clipping-in-the-barrow-ruptured-aneurysm-trial
#10
Michael A Mooney, Elias D Simon, Scott Brigeman, Peter Nakaji, Joseph M Zabramski, Michael T Lawton, Robert F Spetzler
OBJECTIVE A direct comparison of endovascular versus microsurgical treatment of ruptured middle cerebral artery (MCA) aneurysms in randomized trials is lacking. As endovascular treatment strategies continue to evolve, the number of reports of endovascular treatment of these lesions is increasing. Herein, the authors report a detailed post hoc analysis of ruptured MCA aneurysms treated by microsurgical clipping from the Barrow Ruptured Aneurysm Trial (BRAT). METHODS The cases of patients enrolled in the BRAT who underwent microsurgical clipping for a ruptured MCA aneurysm were reviewed...
April 27, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29695463/population-based-assessment-of-the-long-term-risk-of-seizures-in-survivors-of-stroke
#11
Alexander E Merkler, Gino Gialdini, Michael P Lerario, Neal S Parikh, Nicholas A Morris, Benjamin Kummer, Lauren Dunn, Michael E Reznik, Santosh B Murthy, Babak B Navi, Zachary M Grinspan, Costantino Iadecola, Hooman Kamel
BACKGROUND AND PURPOSE: We sought to determine the long-term risk of seizures after stroke according to age, sex, race, and stroke subtype. METHODS: We performed a retrospective cohort study using administrative claims from 2 complementary patient data sets. First, we analyzed data from all emergency department visits and hospitalizations in California, Florida, and New York from 2005 to 2013. Second, we evaluated inpatient and outpatient claims from a nationally representative 5% random sample of Medicare beneficiaries...
April 25, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29683965/effect-of-dexmedetomidine-on-cerebral-vasospasm-and-associated-biomarkers-in-a-rat-subarachnoid-hemorrhage-model
#12
Young Song, Beom Jin Lim, Do-Hyeong Kim, Jin Woo Ju, Dong Woo Han
BACKGROUND: The α2 adrenergic agonist dexmedetomidine (DEX) has huge potential for protecting against cerebral vasospasm, a leading cause of death and disability after subarachnoid hemorrhage (SAH). Biomarker assays for SAH have recently emerged as tools for predicting vasospasm and outcomes. We investigated the effects of DEX on vasospasm and assessed relevant biomarkers in a rat SAH model. METHODS: Male Wistar rats were randomly assigned to sham (n=10), vehicle (n=10), SAH (n=10), or SAH+ DEX (n=10) groups...
April 20, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29682020/morphometric-analysis-of-dose-dependent-effect-of-progesterone-on-experimental-vasospasm-induced-rat-femoral-arteries
#13
Metin Kasap, Huseyin Canaz, Gokhan Canaz, Mehmet Tokmak, Alper Bingul, Ibrahim Alatas
Objective: Our aim of this study was to determine effective doses of progesterone which has a vasodilatory effect during the early stage of vasospasm. Cerebral vasospasm (CV) is a predominant cause of morbidity and mortality which develops following subarachnoidal hemorrhage (SAH). Etiopathogenesis of CV is multifactorial. Despite many previously performed studies on this issue, the mechanism by which blood and blood products in the subarachnoidal space induce CV has not been clarified yet...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682015/spinal-cerebrospinal-fluid-drainage-for-prevention-of-vasospasm-in-aneurysmal-subarachnoid-hemorrhage-a-prospective-randomized-controlled-study
#14
Sachin Anil Borkar, Manmohanjit Singh, Shashank Sharad Kale, Ashish Suri, Poodipedi Sarat Chandra, Rajender Kumar, Bhawani Shankar Sharma, Shailesh Gaikwad, Ashok Kumar Mahapatra
Introduction: Cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is a major cause of mortality and morbidity. Despite various treatment modalities, the optimal management of vasospasm remains elusive. In this regard; we undertook a prospective, randomized controlled study to evaluate the effectiveness of lumbar cerebrospinal fluid drainage (LCSFD) for prevention of cerebral vasospasm and its sequelae. Materials and Methods: Patients with aneurysmal SAH who met the inclusion criteria were randomized into two groups - Group I (30 patients) underwent LCSFD whereas Group II (30 patients) did not undergo LCSFD...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29672747/stress-in-patients-with-un-ruptured-intracranial-aneurysms-vs-population-based-controls
#15
Arno de Wilde, Paut Greebe, Gabriël J E Rinkel, Ale Algra
BACKGROUND: Stress is associated with increased risk of stroke and might predispose to presence and rupture of intracranial aneurysms. OBJECTIVE: To study the association of recent and lifelong stress with unruptured intracranial aneurysm (UIA) and aneurysmal subarachnoid hemorrhage (ASAH). METHODS: In 227 UIA patients (mean age 61 ± 11 yr), 490 ASAH patients (59 ± 11 yr), and 775 controls (51 ± 15 yr) who were randomly retrieved from the general population, we assessed occurrence of major life events and perceived stress during the preceding 12 mo and the entire life...
April 17, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29656002/dangers-of-outpatient-nimodipine-use-after-spontaneous-subarachnoid-hemorrhage-in-accordance-with-the-comprehensive-stroke-center-guidelines
#16
Ching-Jen Chen, Cassie Turnage, Jennifer D Sokolowski, Jeyan S Kumar, M Yashar Kalani, Min S Park
Despite the adverse effects and unclear benefit of the complete 21-day course of nimodipine therapy, The Joint Commission mandates adherence to nimodipine treatment for 21 days after hemorrhage or after hospital discharge if discharged within 21 days for Comprehensive Stroke Center (CSC) certification. We hereby present a 67 year-old male patient with Hunt-Hess grade 2 and Fisher grade 3 non-aneurysmal spontaneous subarachnoid hemorrhage who was discharged with oral nimodipine as stipulated by the CSC guidelines, and subsequently developed symptomatic hypotension...
June 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29649643/estimating-the-global-incidence-of-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-for-central-nervous-system-vascular-lesions-and-meta-analysis-of-ruptured-aneurysms
#17
REVIEW
Joshua D Hughes, Kamila M Bond, Rania A Mekary, Michael C Dewan, Abbas Rattani, Ronnie Baticulon, Yoko Kato, Hildo Azevedo-Filho, Jacques J Morcos, Kee B Park
INTRODUCTION: There is increasing acknowledgement that surgical care is important in global health initiatives. In particular, neurosurgical care is as limited as 1 per 10 million people in parts of the world. We performed a systematic literature review to examine the worldwide incidence of central nervous system vascular lesions and a meta-analysis of aneurysmal subarachnoid hemorrhage (aSAH) to define the disease burden and inform neurosurgical global health efforts. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to estimate the global epidemiology of central nervous system vascular lesions, including unruptured and ruptured aneurysms, arteriovenous malformations, cavernous malformations, dural arteriovenous fistulas, developmental venous anomalies, and vein of Galen malformations...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29626133/long-term-risk-of-hemorrhagic-stroke-in-young-patients-with-congenital-heart-disease
#18
Kok Wai Giang, Zacharias Mandalenakis, Mikael Dellborg, Georgios Lappas, Peter Eriksson, Per-Olof Hansson, Annika Rosengren
BACKGROUND AND PURPOSE: The risk of ischemic stroke is increased in patients with congenital heart disease (CHD); however, data on the risk of hemorrhagic stroke, including intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH), are lacking. METHODS: The Swedish Patient Register was used to identify all patients who were born with a diagnosis of CHD between 1970 and 1993. Each patient was compared with 10 randomly selected controls from the general population, matched for age, sex, and county...
May 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29619929/depression-stroke-and-dementia-in-patients-with-myocardial-infarction
#19
Jens Sundbøll
The connection between the heart and mind has been studied since Sir William Harvey observed more than 350 years ago that negative emotions adversely affect the heart. Today, we know that diseases of the mind can affect the heart and, conversely, that heart diseases can cause both physical and mental diseases of the brain. To explore this relation further, we examined how previous depression affects survival in patients with myocardial infarction (MI) (study II), and how the occurrence of MI affects the risk of ischemic and hemorrhagic stroke (study III) and dementia (study IV)...
April 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29609651/the-use-of-standardized-management-protocols-for-critically-ill-patients-with-non-traumatic-subarachnoid-hemorrhage-a-protocol-of-a-systematic-review-and-meta-analysis
#20
Shaurya Taran, Vatsal Trivedi, Jeffrey M Singh, Shane W English, Victoria A McCredie
BACKGROUND: Caring for patients with subarachnoid hemorrhage (SAH) presents unique challenges, due in part to the severity of the underlying insult, competing systemic injuries, and unpredictable clinical course. Even when management occurs in dedicated critical care settings, treatment uncertainty often persists, and morbidity and mortality from the condition remain high. Complex decisions in SAH care may be simplified with the use of standardized management protocols (SMPs). SMPs incorporate evidence-based guidelines into a practical framework for decision-making, thereby providing clinicians with an algorithm for organizing treatments...
April 2, 2018: Systematic Reviews
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